Development and Evaluation of a Smartphone-enabled, Carer-supported
Educational Intervention for Management of Disabilities Following Stroke
in India

Kamalakannan, SK;
(2016)
Development and Evaluation of a Smartphone-enabled, Carer-supported
Educational Intervention for Management of Disabilities Following Stroke
in India.
PhD (research paper style) thesis, London School of Hygiene & Tropical Medicine.
DOI: https://doi.org/10.17037/PUBS.03449326

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Abstract

Background
The incidence and prevalence of stroke in India has reached epidemic proportions and is
considered a major public health problem. Given the nature of the condition, affected
individuals often become disabled, with profound effects on their quality of life. This study
aimed to develop an educational intervention for management of post-stroke disability in
India and to evaluate the feasibility and acceptability of delivering this intervention using
Smartphone technology and caregiver support.
Objectives:- To systematically develop a Smartphone-enabled, carer-supported, educational
intervention that is multi-disciplinary, patient-centred and culturally-sensitive for
management of disabilities following stroke in India. -To evaluate the feasibility and acceptability of the intervention by stroke survivors
and their caregivers in the Indian context.
Methodology
The study was conducted in Chennai, India, and was implemented in three phases:
Phase 1: Development of the intervention
Phase 2: Field-testing and finalising of the intervention
Phase 3: Piloting of the intervention and assessment of feasibility and acceptability.
A mixed methods approach was used to develop and evaluate the intervention.
Results
The intervention was systematically developed and titled ‘Care for Stroke’. It was delivered
through a web-based, Smartphone-enabled application. During field-testing, key uncertainties,
such as issues with connectivity, video streaming, picture clarity, quality of the videos and
functionality of the application, were identified. The intervention was reviewed, revised and
finalised before pilot-testing. Findings from the pilot-testing showed that the ‘Care for Stroke’
intervention was feasible and acceptable in an Indian context. Over 90% of the study
participants felt that the intervention was relevant, comprehensible and useful. About 95% of
the stroke survivors and all the caregivers (100%) rated the intervention to be excellent, based
on its overall credibility, usability and user-friendliness.
Discussion
‘Care for Stroke’ is an innovative educational intervention that can empower stroke survivors
and their families to be cognisant of their disability, ways to manage it and how to make
appropriate decisions on their road to recovery. The current context for stroke rehabilitation
provides a reasonable opportunity for public health practitioners to optimise interventions
such as ‘Care for Stroke’ to efficiently bridge the gaps in accessibility of stroke rehabilitation
services and enhance the continuum of care for stroke survivors worldwide. The intervention
is specifically pertinent to India and many other Low and Middle-Income Countries (LIMCs)
where resources for improving access to stroke rehabilitation services are inadequate.
Conclusion
‘Care for Stroke’ is an innovative effort towards the global need for research to develop
interventions that bridge the barriers to the provision of stroke rehabilitation services and
meet the needs of affected individuals. This application and similar approaches that harness
the potential of current technology need to be researched further to bridge the gaps in access
to stroke services worldwide.